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Ogilvie syndrome, an uncommon condition characterized by acute colonic pseudo-obstruction. This presents unique diagnostic and management challenges. It is particularly difficult because it usually occurs in patients with a complicated medical history and is associated with variable outcomes.A 61-year-old gentleman with cervical fracture-induced paraplegia, gastritis, and hemorrhoids presented with a distinct manifestation of Ogilvie syndrome. The patient presented with symptoms of abdominal distension, fever, shortness of breath, and a 2-week history of no bowel movements. The presence of comorbidities and the common occurrence of constipation complicate the diagnostic process. Radiological imaging revealed extensive colonic dilation from the cecum to rectosigmoid junction. The patient’s management included a conservative approach involving intravenous fluids, intermittent aspiration, antibiotic therapy, and vigilant monitoring. As a result, the patient displayed improved clinical parameters, reduced abdominal distension, and gradual return of bowel function. However, the patient’s intricate medical history continues to pose ongoing challenges, necessitating long-term follow-up. Previous cases of Ogilvie syndrome were retrieved from PubMed to characterize the clinicopathological features and identify prognostic factors of Ogilvie syndrome.This case highlights clinical acumen in distinguishing Ogilvie syndrome, which presents symptoms of acute emergency abdomen and intestinal obstruction, as opposed to constipation with chronic and non-specific abdominal discomfort.

Background Solid organ transplant (SOT) recipients have an elevated malignancy risk due to long‐term immunosuppression; however, the risk of colorectal cancer (CRC) is not well characterized, and current screening guidelines are not tailored to this population. Methods We used the TriNetX U.S. Collaborative Network to identify adults with SOT (kidney, liver, heart, or lung transplantation) between 2005 and 2025. SOT patients were propensity‐score matched 1:1 to non‐transplant controls, and CRC incidence at the 10‐year and 20‐year follow‐up was compared. Sensitivity analyses evaluated CRC incidence before (2015–2019) and after (2020–2024) the COVID‐19 pandemic onset. Results We identified 90 510 SOT recipients (matched to 90 510 controls from 9.8 million general patients). After matching, the baseline characteristics were balanced. SOT recipients had a higher cumulative incidence of CRC than controls at both 10 years (0.17% of kidney transplant patients vs. 0.02% of controls; p < 0.001) and 20 years posttransplantation. This elevated risk was observed across the kidney, liver, lung, and heart transplant cohorts (odds ratios: 1.3 for CRC in SOT vs. non‐SOT at 10–20 years). Additionally, CRC incidence was higher in the post‐COVID era compared to the pre‐2019 era in all SOT groups (e.g., kidney 0.25% vs. 0.14%). This increase was most pronounced in older recipients (≥ 70 years) and Hispanic patients. Conclusion SOT recipients in the United States exhibit a significantly higher long‐term CRC risk, a disparity that appears to have widened after the pandemic. These findings underscore the need to revisit CRC screening strategies in SOT recipients, particularly older and long‐term transplant survivors.

Introduction: The exact etiology of acinar cell cystadenoma (ACC) has been debated, primarily whether it originates from or carries the risk of an underlying neoplasia. Pancreatic intraepithelial neoplasia (PanIN) is presumed to be a noninvasive precursor of pancreatic ductal adenocarcinoma. This report presents a rare case of ACC with low-grade PanIN that required surgical resection. Case Presentation: A 60-year-old female with an unremarkable medical history presented with epigastric pain for 2 weeks. Her initial laboratory workup was notable for mild isolated elevation of alkaline phosphatase. Abdominal computed tomography revealed a 5.0 × 4.0 cm cystic lesion in the pancreatic head with thick internal septations. Magnetic resonance cholangiopancreatography showed a 5.2 × 4.5 × 6.8 cm lobulated cystic lesion in the pancreatic head with a microcystic configuration, multiple internal septations, and a hypointense central scar. Endosonographic examination showed a large multicystic lesion in the pancreatic head region. Fine-needle aspiration showed a carcinoembryonic antigen level of 555 ng/mL and an amylase level of 13,593 U/L. No KRAS or GNAS mutations or loss of heterozygosity was detected. Subsequently, the patient underwent a Whipple procedure. Pathologic examination revealed a complex cystic lesion with well-differentiated acinar cells and patches of ductal epithelium compatible with ACC. Histological examination confirmed the presence of low-grade PanIN without invasive carcinoma. The patient recovered well from surgery, and repeat imaging 2 months later was unremarkable. Conclusion: ACC is a rare benign pancreatic lesion. Low-grade PanIN is typically found in benign pancreatic lesions. Resection is recommended for symptomatic patients.

Introduction: Mixed acinar-neuroendocrine carcinoma (MANEC) is a rare variant of pancreatic carcinoma, the morphology of which shows features of both acinar cell carcinoma and neuroendocrine carcinomas. To date, only approximately 70 cases of MANEC have been reported. Case Presentation: We report a rare case of a 63-year-old male cirrhotic patient who presented with a pancreatic body/tail mass, which was later confirmed to be an MANEC. He was initiated on neoadjuvant chemotherapy with FOLFIRINOX, but unfortunately died before surgery. Conclusion: MANEC is a rare sporadic tumor of the pancreas. Further studies on the clinicopathological behavior of MANEC are needed to help better understand the disease and establish standardized management.

Background Synovial osteochondromatosis is a rare, benign condition characterized by the formation of cartilaginous nodules within the synovium. It commonly occurs in the anterior compartment of the knee joint and predominantly in middle-aged men. It is relatively unusual in females, and at this remarkable age, there is a greater probability of missed diagnosis. Research Design This case report describes a 63-year-old female with classical synovial osteochondromatosis complicated by a clinically suspected septic arthritis of the right knee. Underlying comorbidities, including hypertension, diabetes mellitus, and hyperlipidemia further complicate patient management. Conclusions We have detailed anesthetic and clinical management strategies to stabilize the patient preoperatively and ensure successful surgical outcomes.

Background/Objectives: Coronavirus disease 2019 (COVID-19) is associated with gastrointestinal (GI) symptoms. Small intestinal bacterial overgrowth (SIBO) is emerging as a significant GI sequela post-COVID-19 infection. This study aimed to evaluate the prevalence and incidence of SIBO post-COVID-19 infection across different age groups and to identify associated risk factors in a global cohort. Methods: A retrospective study utilized the TriNetX database and included adult patients (≥18 years) diagnosed with SIBO following COVID-19 infection (1 January 2022–30 May 2024). A propensity score matching (1:1) was used to adjust for demographics and SIBO risk factors. Kaplan–Meier survival analysis assessed the SIBO incidence within 12 months. Results: Among 1,660,092 COVID-19 patients and 42,322,017 controls, SIBO was diagnosed in 353 COVID-19 patients without hydrogen breath tests (BT) and 78 with BT, compared to 3368 controls without BT and 871 with BT. Age-specific analysis demonstrated a clear, progressive increase in the SIBO incidence, becoming distinctly significant by 6 months and highest at 12 months post-infection. The highest risks were noted in ages 60–69 (0.011% vs. 0.004%, OR 2.6, p = 0.0003) and 70–79 (0.011% vs. 0.005%, OR 2.0, p = 0.0004), with younger age groups (30–49 years) also showing significantly increased risks. The medication analysis revealed strong associations with chronic opioid, proton pump inhibitor, and antidiarrheal medication. Conclusions: COVID-19 significantly increased the risk of SIBO, particularly within the first 12 months post-infection, across various age groups and, notably, in association with certain chronic medications. Clinical vigilance and targeted management strategies are recommended to mitigate long-term GI consequences.

INTRODUCTION Prevalence of obesity in patients with ileal pouch anal anastomosis (IPAA) is rising with recent data suggesting prevalence of 20%. Studies have shown that obesity is associated with negative outcomes in patients with IPAA. Glucagon-like peptide-1 receptor agonists (GLP1RA) are approved anti-obesity medications for which there are data to suggest favorable outcomes in patients with inflammatory bowel disease (IBD), though their impact on patients with IPAA is unknown. METHODS We conducted a retrospective cohort study using de-identified patient data from the TriNetX database, including adult patients diagnosed with ulcerative colitis (UC) who underwent IPAA between January 1, 2005, and January 1, 2025. Patients were excluded if lacking documentation of UC, IPAA surgery, or medication exposure. Two cohorts were defined: patients with an IPAA and GLP1RA exposure, and those without GLP1RA use. GLP1RA exposure required active use during each follow-up interval. Propensity score matching (1:1) was adjusted for demographics and confounders. Logistic regression and a univariate Cox proportional hazards models were used to assess IPAA outcomes, including pouchitis, antibiotic use, steroid therapy, Crohn’s-like disease of the pouch (CLDP), hospitalization, pouch failure, and use of advanced therapies, at 1, 3, and 5 years following GLP1RA exposure (Table 2 legend). RESULTS Before PSM, there were 37, 92, and 140 patients with an IPAA and GLP1RA use over 1, 3, and 5 years; and 5,552, 5,497, and 5,449 with an IPAA without GLP1RA use over 1, 3, and 5 years, respectively. After PSM, 37, 92, and 140 patients were included in each cohort at 1, 3, and 5 years. GLP1RA users were older at IPAA (39.5±16.1 vs 38.6±16.9) and more often obese (Table 1). Incidence of Pouchitis and advanced therapy use were similar between groups (Table 2). GLP1RA use was associated with lower antibiotic use at 3 years (37.0% vs 52.2%, OR 0.54; p = 0.038) and 5 years (37.9% vs 59.3%, OR 0.42; p < 0.001), and reduced steroid use at 3 years (28.3% vs 54.3%, OR 0.33; p < 0.001) and 5 years (28.6% vs 52.9%, OR 0.36; p < 0.001). Hospitalizations were also fewer at 1 year (40.5% vs 64.9%, OR 0.37; p = 0.036), 3 years (42.4% vs 71.7%, OR 0.29; p < 0.001), and 5 years (40.0% vs 67.9%, OR 0.32; p < 0.001). No GLP1RA users experienced pouch failure, and Crohn’s-like disease of the pouch was numerically lower but not statistically significant (Table 2). CONCLUSIONS While GLP1RA use was not associated with differences in the incidence of pouchitis, it was consistently associated with lower rates of antibiotic use, steroid use, and hospitalization at longer-term follow-up. Further studies are needed to better define the impact that GLP1RA exposure has on patients with IPAA, including more granular outcomes such as clinical disease activity scores and pouchoscopy.

This systematic review explores the complex relationship between artificial intelligence (AI) and healthcare, with an explicit focus on nursing care. Examining a range of studies from 2020, the research investigates the impact of AI on clinical decision-making, patient care and healthcare administration. Through a comprehensive literature review, the study highlights the potential benefits of AI integration in improving the efficiency and efficacy of healthcare. AI technologies offer opportunities for personalised patient care, predictive analytics and enhanced clinical processes, with the ultimate aim of transforming the healthcare system. However, ethical considerations and regulatory frameworks are crucial, emphasising patient privacy, autonomy and data security. The findings underscore the need for transparency, accountability and fairness in the application of AI in healthcare. While AI promises to improve patient outcomes and streamline healthcare delivery, careful consideration of ethical implications and regulatory compliance are essential for responsible implementation.